Body Dysmorphic Disorder (BDD) Therapy & Treatment
Do you spend a great deal of time obsessing about a particular aspect of your appearance? Do you think that a certain part of your body is seriously flawed? Do you devote a great deal of time trying to hide or improve the areas of your body that concern you? Do you have a difficult time believing people when they tell you that you look fine? If you answered “yes” to these questions, you may be experiencing something called Body Dysmorphic Disorder (BDD).
Much like Obsessive Compulsive Disorder (OCD), Body Dysmorphic Disorder (BDD) has both obsessive and compulsive features.
Body Dysmorphic Disorder is categorized by a severe preoccupation (obsession) with an imagined flaw in one’s physical appearance. The obsession can be about any body part and it can change over time. Individuals with BDD are often concerned that the body part is not the right shape, out of proportion to the rest of their body, too small, too big or asymmetrical in some way.
Some examples of common obsessions found in BDD include:
- Nose size or shape
- Overall face or body shape
- Genital size or shape
- Thinning or excessive hair on head or body
- Teeth, lips, smile or mouth
- Skin, including acne, wrinkling, freckles, scars or complexion
- Jaw, cheeks or chin
- Breasts, buttocks
Individuals with Body Dysmorphic Disorder often spend a great deal of time evaluating or worrying about a specific feature of their appearance, which leads to body-related anxiety, which in turn leads to compulsive or avoidant behaviors meant to reduce anxiety, that include:
- Spending a great deal of time checking one’s appearance in the mirror
- Avoiding mirrors
- Comparing one’s appearance to others
- Avoidance of having picture taken
- Repetitive measuring, touching or checking the area of concern
- Trying to conceal or hide the minor or imagined defect
- Asking family members, friends, and professionals about your appearance
- Multiple medical procedures in an attempt to fix the area of concern
Because the features of Obsessive Compulsive Disorder and Body Dysmorphic Disorder are so similar, the same Cognitive Behavioral Therapy (CBT) treatments that are so effective for OCD are also utilized when treating BDD. However, most individuals with Body Dysmorphic Disorder do not seek psychological help, but instead look for expensive surgical, dental or dermatological treatments to fix their imagined defects and flaws, which often worsen their symptoms of BDD.
Four recent studies have found have found CBT to be very effective in reducing the severity of BDD as well as related symptoms of depression and anxiety. Working together, the CBT therapist and client develop an individualized model of BDD that is based on the client’s specific symptoms. This includes theories of how the negative body image problems initially developed and how they are now maintained with avoidance and rituals. The CBT therapist and client identify the triggers for the negative thoughts about the client’s appearance, the interpretation of these thoughts, as well as the client’s emotional reactions and negative coping skills. CBT treatment for BDD includes cognitive approaches that focus on identifying negative, unhelpful thoughts, evaluating the validity of these distorted body image thoughts and learning to generate healthier alternative thoughts. As in the treatment for OCD, an additional CBT treatment approach for BDD consists of exposure and response prevention (ERP). ERP for BDD has been found to greatly reduce the intensity and frequency of negative body image obsessions.
Applying these tools, CBT therapists at GroundWork Counseling help individuals with Body Dysmorphic Disorder learn to confront their negative body image issues and decrease avoidant and compulsive behaviors. If you would like to learn more about CBT for the treatment of Body Dysmorphic Disorder, Obsessive Compulsive Disorder or other Anxiety conditions, please visit: The Center For Anxiety & OCD at GroundWork Counseling.
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